Of interest is that, as of June 2017, all nine voting members of the NACI had declared direct/indirect financial or intellectual conflicts of interest1 within the regulated market including with the following vaccine manufacturers: Alnylam, Astellas, GlaxoSmithKline, Grifols Canada, Hoffmann-La Roche, Novartis, Merck, Sanofi-Pasteur and Wyeth. These conflicts range from consultant fees to research grants to industry-funded education programs to lobbying. The non-voting Chair of the Committee also had declared indirect financial and intellectual conflicts of interest. The six non-voting liaison members of the committee represent the US government CDC (which holds vaccine patents), four health professional trade associations and the Canadian College of Family Physicians, all five of whom advocate with government on behalf of their members (ie, lobbying). One liaison representative declared a research grant from Abbott Pharmaceuticals.

The Public Health Agency of Canada (PHAC) publishes the NACI recommendations in the Canadian Immunization Guide. The recommendations include a routine schedule for childhood vaccinations. However the planning, funding and delivery of vaccine programs are the responsibility of the individual provinces and territories. Therefore, although their vaccine schedules are based on NACI recommendations, they vary from one region to another depending on epidemiological and financial considerations.

Publicly Funded Immunization Programs in Canada

In many provinces and territories vaccines are administered through Public Health only. In some provinces, physicians and pharmacists also administer publicly funded vaccines. Public health nurses administer school vaccine programs in all regions.

As you can see from the map, a total of 19 different vaccines are used for Canadian children. Most regions use 16 different vaccines all of which are on the recommended NACI schedule. Four regions use three vaccines—BCG for Tuberculosis, a 23-valent pneumococcal vaccine and a Hepatitis A vaccine—that are not listed in the PHAC routine childhood vaccine schedule for children.

The number of doses of these 19 vaccines for children also varies by region, from a low of 51 doses in Quebec to high of 70 doses in British Columbia.

How to count the number of vaccine doses your child receives

While most public health literature refers to having “one shot”, in fact there can be as many as 6 vaccines in that one shot since some vaccines are combination vaccines. As the number of vaccines licensed for use in Canada continues to mount, especially for infants, babies and toddlers, vaccines have been combined for “ease of administration”. This “ease” refers to not only the number of visits a parent must make for vaccine administration, but also to the number of limbs available to receive the vaccinations.

The two most notable combination vaccines are the various DTaP vaccines and the MMR or MMRV vaccines. The DTaP vaccines combine 3 vaccines—diphtheria, tetanus, acellular pertussis (for whooping cough)— and then, variously, up to 3 more vaccines—polio (IPV), Hib and Hepatitis B. The MMR vaccine contains 3 vaccines—measles, mumps and rubella. The MMRV contains 4 vaccines— measles, mumps, rubella and varicella (chickenpox).

At an infant’s 2-month “well baby” appointment, most regions give DTaP-IPV-Hib (5 vaccine combination), Pneumococcal-13 (1 vaccine) and Rotavirus (1 vaccine in an oral dose). Therefore your baby will receive a total of 7 vaccines in 2 injections and one oral dose. Meningococcal-C-13 is often added to the above vaccines at the 4-month visit. So in that visit, your baby will receive 8 vaccines. The total doses received are now 15 doses by 4 months of age. At the 6-month visit, your baby will likely receive a third dose of DTaP-IPV-Hib (5 vaccines) and their first Influenza vaccine or 6 vaccines at this visit, The total doses received now is 21 doses by 6 months of age.

Provincial Territorial Schedules

Click below for a pdf of the Childhood Vaccine Schedule in your region:

The VCC provincial/territorial schedules cover a number of aspects of vaccines administered to children in each province and territory.

On page 1 of the schedule, a comparison is made to the number of vaccines received two generations ago (in 1983) by pre-school children to the number of vaccines received in 2017 by this same cohort. In this section vaccines are listed and the number of vaccine doses they contain is counted at each exposure, beginning with prenatal shots to pregnant mothers, birth and 1 month (where applicable), 2 months, 4 months, 6 months and so forth up to 6 years of age.

Then vaccines received in school are itemized at grade level or age received. A count of doses and number of injections is stated.

A grand total is given for all vaccine doses from prenatal to age 18 is then noted. The grand total is the number noted on the map above. The variances within a province of territory are based on gender and ethnicity. For example, HPV is only given to girls in some regions. So girls will have 2 or 3 more vaccine doses than boys in those provinces; HepA vaccine is based on ethnicity. In BC and Saskatchewan aboriginal children are given 2 or 3 doses.

At the bottom of page 1, the following reminder is added to each schedule:

Did you know vaccination is VOLUNTARY in Canada?

As Health Canada explained years ago: “Unlike some countries, immunization is not mandatory in Canada; it cannot be made mandatory because of the Canadian Constitution…legislation and regulations must not be interpreted to imply compulsory immunization.” —Immunization in Canada, Volume: 23S4, May 1997, Canadian National Report on Immunization

Page 2 of the schedule contains a legend that describes each of the vaccines and gives the product names used in the region. This assists parents in being able to ask which vaccine brand their child will be receiving. Live vaccines are also noted with a quote and link on live vaccine shedding and mutations.

Then information on program administration (public, private or both) and links to useful documents such as informed consent, mature minor consent and consent forms where available, adverse event reporting and other regional specific information.

The right hand column of page 2 gives a vaccine schedule for the first year of life and examines ingredients in the brand name vaccines listed and briefly discusses effects of exposure. See our Ingredients page for a more complete discussion.

Both aluminum and mercury (Thimerosal) exposures are totaled. The mercury exposure is from quadrivalent Influenza vaccines. Northwest Territories still uses a trivalent vaccine with no mercury. Below is a comparison chart of aluminum and mercury for each province using the proposed brand name products itemized on the schedule for each region. Please note the amounts will vary depending on the product used. See Note 2 below for more information on these vaccine ingredients.

NOTE: Product monographs give much more detailed information for contents of vaccines than the above link, including in most cases amounts of mercury and aluminum, fetal cell lines, etc. If you don’t find details you are looking for just search for “product monograph + vaccine trade name + country”. Australia and the USA both have more detailed information in their manufacturer monographs than found in Canadian manufacturer monographs.

“Ten of Canada’s largest pharmaceutical companies together spent at least $48.3-million on payments to physicians and health-care organizations last year, according to figures the drug makers voluntarily divulged on Tuesday.

The disclosures provided a peek into how Big Pharma compensates this country’s physicians for consulting, delivering speeches, sitting on advisory panels and travelling to international medical conferences.

But the companies released so few specifics that some prominent doctors dismissed the revelations before they even took place, calling the disclosures little more than an attempt to keep governments from legislating genuine transparency.

…Only 10 of the 45 members of Innovative Medicines Canada (IMC), the industry association for brand-name drug makers, took part in the voluntary disclosure effort.”

“A Globe and Mail analysis found financial conflicts of interest are commonplace in clinical practice guidelines. As 10 major Canadian pharmaceutical players prepare to release their total payments to physicians, some prominent doctors are dismissing the limited disclosure as meaningless.”